high/intermediate) and between subjective change of symptoms (unchanged vs. relieved). These analyses did not yield any relevant and consequential additional information on the relation of texture features to grouping parameters. Discussion The goals

of this study were show that a) MRI texture analysis can be used in NHL chemotherapy response evaluation b) statistical tests Wilcoxon paired test and R&R can be used to evaluate the separability of texture parameters used to describe textural changes in NHL. Limitations of our study may be the non-standardized MRI sequence protocols within intra and inter patient images and the use of different slice thickness due check details to imaging in clinical practice, where patient’s clinical stage and the size of the tumor were taken into account when setting imaging parameters. However, multicenter studies on MRI TA have shown transferability of TA parameters achieved from MRI images Osimertinib obtained

at different MRI centers with own acquisition parameters [16, 38]. To achieve new clinical relevant information by means of texture analysis, the texture changes should come out at the same or earlier timepoint as other quantitative measures of tumor response, for example decrease in tumor volume. The RECIST and WHO criteria for evaluating tumor response in one- or two-dimensional (diameter and product) tumor size is equivalent to a 65% decrease in tumor volume [1]. In this study we calculated tumor size decrease in

a short time period: before and after the first cycle of chemotherapy. There are no commonly used criteria for early response assessment using volumetric analysis for use as early in the therapy course as our volumetric evaluation was performed. Considering this, we can use the volumetric results as indicative of early imaging based evaluation of response, not to meet response, and also accept tumor volume decrease percentages smaller than 65% as consequential decrease in tumor size. However, in lymphomas, final clinical response evaluation should include other clinical tests according Methocarbamol to [5, 6]. Wilcoxon test showed encouraging values in the analyses of E1 and E3, including transferability of feature sets between T1- and T2-weighted images. This confirms our recent results with smaller patient data MaZda texture analysis of combination of T1- and T2-weighted images in single analysis [32]. Our study show that the statistical and autoregressive model texture parameters of MRI data can be successfully tested one by one with Wilcoxon paired test and Gage Repeatability and Reproducibility test to assess the impact of parameter separability in evaluating chemotherapy response in lymphoma tissue. Our results strengthen the applicability of Fisher and POE+ACC methods used in MaZda for automatic feature selection, and also confirm the suitability of the raw parameters in statistical tests.